Special requests for testing should be noted on the requisition.If submitting more than one specimen per patient, and specimens need to be stored and transported at different temperatures, use separate bags and Lab Request forms for each temperature type. Fold completed request form and place in the outside pocket of the Specimen Bag.Please provide all information on the left hand side of the request form.Complete a separate Clinical Lab Request form for each patient. ![]() ![]() If the Department of Laboratory Medicine offers a procedure that does not appear on the request form, print plainly the full name of the test desired in the space marked “OTHER REQUESTS”. Authorization for laboratory work, include the name of the ordering physician and UPIN in addition to the name and address of the facility to which the results will be sent.Source of specimen and/or other comments in “comments” box.The sensitivity was low at 42, although the specificity was 90, and the positive predictive value of this test was excellent at 91. Results: The Western blot for hsp 70 is the best test for predicting corticosteroid responsiveness. Interval and total volume if a timed urine collection 1 Department of Otolaryngology, University of Washington, Seattle 98195-6515, USA.Patient fasting conditions (if applicable).Type of specimen submitted, indicate serial and timed collection.Patient name, sex, birth date, include unique I.D. ![]() This study evaluated Euroline WB for the detection of HSV-2 antibodies compared with University of Washington Western blot in three geographically different regions: Baltimore, MD, USA Rakai. Each requisition form for laboratory services must clearly identify: The Euroline Western blot (WB) is a commercially available assay that is easy to perform however, little is known about its performance characteristics. Laboratory procedures are performed ONLY upon a physician’s written request. Submission of requests for laboratory testing should be accompanied by the Clinical Lab Request Form.
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